Published: 2019-05-28

Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital

Romaric Joel Tetsiguia Momo, Jeanne Hortence Fouedjio, Florent Ymélé Fouelifack, Robinson Enow Mbu


Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.

Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.

Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).

Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.


Fetal death, Intrauterine, Risk factors, Ultrasound, Yaoundé

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Blencowe H, Cousens S, Jassir FB, Say L, Chou D, Mathers C, et al. Stillbirth epidemiology investigator group. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Heal. 2016;4(2):98-108.

Cousens S, Blencowe H, Stanton C, Chou D, Ahmed S, Steinhardt L, et al. National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis. Lancet. 2011;377 (9774):1319-30.

Quibel T, Bultez T, Nizard J, Subtil. Morts fœtales in utéro. Journal de gynécologie obstétrique et biologie de la reproduction. 2014;43:883-907.

Akolekar R, Tokunaka M, Ortega N. Prediction of stillbirth from maternal factors, fœtal biometry and utérine artery doppler. Ultrasound Obstet Gynecol. 2016;48(5):631-5.

Flenady V, Middleton P, smith GC, Dube W. Still birth: the way forward in highincome countries. Lancet’s still births series steering committee. Lancet’s still births series steering committee. Lancet. 2011;377:1703-17.

AliyuMh, Salihu HM, Keith Lg, Ehiri JE. Extrem parity and the risk of stillbirth. Obstet Gynecol. 2005;106:446-53.

Andriamandimbison Z, Randriambololona DMA, Rasoanandrianina BS. Étiologies de la mort foetale in utero: à propos de 225 cas à l'hôpital de Befelatanana Madagascar: Médecine et Sante´ Tropicale. 2013;23:78-82.

Charle V, Fatimata L. Grossesse chez la célibataire à Niamey. Afr J Reprod Health. 2001;5(2):98-104.

Cabrol D, Pons JC, Goffinet F. Mort foetale in utero. Traité d’Obstétrique. Paris: Médecine-Science Flammarion. 2003:353-8.

Conde-Argudelo A, Belizan JM, Diaz-Rosselo JL. Epidemiology of fetal death in Latin America. Acta Obstetrica Gynecol Scand. 2000;79:371-8.

Ashish KC, Viktoria N, Wrammert J, Uwe , Ewald. Risk factors for antepartum stillbirth: a case-control study in Nepal. BMC Pregn Childbirth. 2015;15:146.

Sonal A, Nandita K. Aetiological classification of stillbirth; a case control study. J Obstet Gynaecol India. 2016;66(6):420-5.

Uzan M, Haddad B, Uzan S. Hematome retroplacentaire. Encycl Med Chir, Paris: Elsevier, Obstet. 1995;5-071-A-10.

Nahar S, Rahman A, Nasreen HE. Factors influencing stillbirth in Bangladesh: a case-control study. Paediatric Perinatal Epidemiol. 2013;27:158-64.

Tantbirojn P, Saleemunddin A, Sirois K, Crum CP, Boyd TK. Cross abnormalities of the umbilical cord: related placental histology and clinical significance. Placenta. 2009;30:10838.